Anyone having or had a vbac?

My youngest, Jace, was born via c-section after laboring & pushing for 2 hours. I always felt I could have pushed him out if I had been able to squat for the delivery, lol, but they had me stuck on my back. He was 10 lbs 3oz, but his head circ was average.

Ob mentioned that we could try a vbac if both babies were head down. I'm scared either way. Surgery was SO HARD to recover from. My vaginal deliveries were very easy, I was up and around like nothing happened an hour later. On the other hand, there is a risk to a vbac, and even though it is small, my last baby died due to an umbilical cord accident (a 1% risk, and it happened to him). His birth was vaginal (just this past June), but he was only 17 weeks gestation and only 6.5" long.

Anyone on here going to try a vbac or been successful with one? Can they accurately monitor both babies during delivery/labor? If something were to go wrong during labor, could they really get them out quickly?

 

Wow momma. :grouphug:

Can certainly see why you've got some worry anticipating your twins' birth. Never had a VBAC; my twins were my first. But I did deliver them vaginally, and I'd say that if you've had good vaginal deliveries before, delivering twins might go smoothly. Mine was a wonderful experience.

I'd think it over and see what your doc recommends. If you decide to go vaginally, find a supportive doc you can trust. If you decide to go for a repeat c/s, ask around for the best doc for that too. Recovery might not be as bad with another surgeon.

No real help, but I could read and not give you a hug! Best wishes for a good pregnancy and delivery!

 

There are so many things that go into a vbac. How was your c-section performed? (what cuts - vertical or horizontal, inside & out) There is a sticky in the pregnant after twins forum about VBACs. I had a vbac after my twins. I only had a section because my twin A was breech. I had a 10 lbs VBAC baby laboring on my back. I had not failure to progress. I pushed him out in 22 minutes.
What does your doctor say? His s/he pro-vaginal delivery? Would s/he be willing to give you a chance? Good luck. Bottom line. You want healthy babies. No matter how they come out, they are still precious. You did not fail by having to have a c-section. I didn't want one with the twins, but with Twin A being breech, I had no choice.

 

My peri trained with the author of the original vbac paper, so he has a lot of experience with them. His criteria for attempting a vbac with twins is that both babies must be head down, and labor must occur spontaneously -- ie no induction.

He would let me attempt a vbac if I wanted to, but when asked for his honest opinion, said if he were pregnant with twins he personally would not take the risk. The risk of uterine rupture is only 1-2%, but if it happens he said it can be catastropic, possibly resulting in death for the mother or a baby. Apparently he's been called in to consult on a few cases where things have gone very, very wrong.

My recovery from the c-section with my first child was pretty easy. Although I was dead-tired for the first 24 hours, I was up and walking around the next day -- plus DH had to change all the nasty early diapers! If I were having a singleton I'd probably attempt a vbac, and at first I really wanted to do a vbac with the twins. I thought about it a lot, but with the extra stretching and needing to get two babies out safely if something went wrong I've decided upon a repeat c-section for myself. I just couldn't find a reason in favor of the vbac that outweighed the seriousness of the risk.

 

Hi,

My son was born via c-section. I was induced with him due to pre-e but I never dilated past 2 cms so they opted for a c-section. Now I am pregnant with twins and my ob says I don't have a choice but to have a csection. He literally said that I risk my uterus exploding (his words not mine). So they aren't even giving me the option even if they are heads down. Recovery is difficult I know, but if that's the safest option, I will go with what my ob and peri say.

Jennifer

 

Let me preface my remarks by saying, I've had a vbac, and I'm currently planning on another. I've done a lot of research about vbac, and I did a lot of research on twin vaginal deliveries. I did not have a twin vaginal delivery because my baby A went transverse. I think there are a lot of things for you to consider. If I were in your shoes some of the things I would be concerned with...

1. How truly pro-vbac your doctor is. A pro-vbac doctor will insist on a spontaneous start to labor with very minimal intervention with drugs. Labor promoting drugs are almost without fail bad news for vbac success odds. Along with this notion...what are the odds that you will be allowed to go far enough along with twins for your body to go into labor. Many twin moms could go past 39 or 40 weeks without labor starting on its own. If they are not vbac patients most doctors would induce them by 39 weeks.

2. how comfortable is your doctor in an emergency situation. What is his/her procedure for turning a baby B that flips after Baby A comes out... what is his/her experience with a labor that goes long between the birth of baby A and baby B. There's a ton of variables related to twin vaginal delivery that has nothing at all to do with vbac, but which you need to be aware of and discuss with your doctor. For instance, many doctors do not do breech extraction, so if baby B flips and they can't get him/her to turn they will automatically start up a c/s to get baby B out. You need to know which direction your doctor would take, so that you are comfortable getting into that situation. I had one doctor who would've pulled the trigger for c/s over a flipped baby B and one doctor who was totally comfortable reaching up and pulling baby B out by the feet if need be. It has to do with their training and experience, and you can't ask them to do something they aren't comfortable doing.

3. Look at the odds of success of vbac versus twin labor. There is a lot of anxiety on the part of doctors over vbac in general. Throwing two babies to monitor adds possible anxieties by like a factor of 10. 50% of all induced labors, regardless of vbac or twins, will wind up in c/s. 70% of routine, non-induced, non-augmented vbac labors will be successful, but as soon as you throw in epidurals and pitocin the odds of success starts decreasing. For many doctors, they are not comfortable doing twin labors without epidurals because of the chance of needing a c/s. It's a lot riskier to need to knock out a woman with general anesthesia than to have her prepped with an epidural and ready to go 'just in case.' So many doctors prefer to 'manage' twin labors with epidurals, and then pitocin as a result of the epidural reducing contraction strength or regularity.

4. How comfortable are you with the risks? Given your history, especially losing a child, you have a lot to think about. I know that I was anxious over trying a vaginal twin delivery even without having that sad history. You may find relief in just opting for a c/s where the risks are better known to you. On the other hand, to me it seems as though your last baby's death was really not caused by the delivery itself, but something that happened prior to the delivery which then caused your body to go into labor at 17 weeks?

5. Realize that at the end of this you may have no choice. I really wanted a vaginal delivery with my twins. My first dd had been born vaginally so I knew I could do it. However, my baby A flipped transverse at 35 weeks. So at the last minute, just 2 weeks before birth I no longer had the option of vaginal delivery. I was disappointed, but at the same time relieved that I didn't have to go through what I perceived as a bit of gamble... not only needing to get through the birth of baby A, but that big question over what will baby B do once baby A is out??


6. Do you plan on having more children? If the answer is 'yes' then a doctor might be more supportive of a vbac, and you might have more incentive for one.

7. Do realize that a planned c/s is normally much easier than an emergency one. By emergency, I mean any c/s which comes after hours of labor and/or pushing. A planned c/s has you mostly well-rested without going through labor. Most anectdotal stories I know of from moms who have gone through both testify that their planned c/s was easier to recover from. So hold on to that positive thought if you do decide to go for the planned c/s.

My end comment... if you do decide to go for vbac make the commitment to go for it with all your guns pulled. Make sure your doctor is okay with natural labor. Be prepared for natural labor. Get labor support. All the statistics overwhelmingly support the idea that natural labor is by far the best way to give you the highest odds of success at vbac. As soon as other interventions are introduced your odds of success begin to decline. It doesn't mean their aren't plenty of women who get an epidural who won't have their vbac, but there are less of them than of those who go naturally. The trouble is that these interventions adds yet another layer of variables for the doctor to interpret. Is the heart decel due to the epidural? the pitocin? or a ripping uterus? The mother can no longer tell the doctor her symptoms or pain level because she doesn't feel anything... so there's no help there. Some doctors may panic more than others over heart decels that can be totally normal during labor or after an epidural or pitocin.

You really have to ask your doctor a lot of detailed questions about how he/she approaches vbac labors. Know your statistics (you can find a lot on the ACoGyn website -american college of ob/gyn I think it's called-), and go in 'playing dumb' just to see if your doctor is informed AND honest about the statistics involved. It really is eye-opening to watch your doctor either outright lie or be misinformed versus seeing that your doctor has confidence and knows the numbers inside and out. I found both kinds of doctors at the practice that I had my vbac through. I never confronted the doctors who were less than honest or less informed, but it did empower me to know which doctors I would have to fight more during labor and which doctors I would rather have!

Hope this helps!

 

Thanks everyone, I really appreciate the advice!

My Peri (I see an Ob & a Peri) told me that he would not induce because of the risk of uterine rupture. I have never gone into labor on my own. All of my births were induced.

I'm leaning towards a scheduled c-section. I just can't go through another loss, and I'm sure labor would have me in a panic the whole time just knowing the risks.

 

I think that you should feel good about the decision whichever way you go. And like I said before, a planned c/s can be so different from an emergency one. There are so many factors that go into a good birth experience. Although, I am a firm believer that vaginal delivery is much better for YOUR body than a c/s, the ironic part is that my c/s delivery with my twins, thus far, has been my most positive birth experience. My vbac, was emotionally the worst experience. It was physically the best to recover from, but it was the most challenging to get through and with a doctor who made me feel horrible about myself and the experience. I'm hoping this time around to get the best of both worlds which is why I'm using a midwife.

But I say all that to encourage you. A planned c/s can be emotionally exillerating. Mine came along with the most euphoric feeling, the closest I've ever gotten to an experience of 'love at first sight.' I just remember bursting into tears seeing the twins and feeling so overwhelmed with love for them. In my other birth experiences there was so much distraction that it took longer for the realty of the baby being 'here' to hit.